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J Thorac Dis. 2017 Dec;9(12):5008-5016. doi: 10.21037/jtd.2017.10.140.

Anemia as a clinical marker of stable chronic obstructive pulmonary disease in the Korean obstructive lung disease cohort.

Author information

1
Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
2
Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea.
3
Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
4
Department of Humanities and Social Medicine, Ajou University School of Medicine, Suwon, Korea.
5
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
6
Division of Pulmonology, Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea.
7
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
8
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.
9
Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Korea University Anam Hospital, Seoul, Korea.

Abstract

Background:

Anemia is a major co-morbidity in chronic obstructive pulmonary disease (COPD). However, the mechanism of development for anemia and the impact of anemia on the prognosis of COPD remain poorly understood. Therefore, this study attempted to evaluate the prognostic role of anemia on the clinical course of COPD and investigate the factors linked with the serum hemoglobin level in COPD.

Methods:

We analyzed 407 COPD patients enrolled in the Korean obstructive lung disease (KOLD) cohort at 16 hospitals in Korea recruited over 9 years. Multivariate Cox regression analysis was performed to find independent predictors of survival and multivariate logistic regression analyses were done to find independent factors.

Results:

Anemic COPD were older with lower body mass index (BMI) (P<0.001), lower serum cholesterol level (P=0.001), lower serum albumin level (P<0.001), and shorter 6-minute walking distance (P=0.046) compared to non-anemic COPD. A multivariate Cox regression analysis revealed that age (P=0.002), BMI (P=0.001), post-bronchodilator forced expiratory volume in 1 second (FEV1) (P=0.007), 6-minute walk distance (P=0.008), anemia (P=0.025) were significant predictors for all-cause mortality. In multivariate regression analysis, older age (P<0.001), female gender (P=0.001), lower BMI (P=0.016), and lower serum albumin level (P<0.001) were independent factors associated with lower serum hemoglobin level.

Conclusions:

Our data showed that anemia was an independent risk factor for mortality in COPD, and aging, lower serum albumin level, and lower BMI were independent factors associated with lower serum hemoglobin level.

KEYWORDS:

Chronic obstructive pulmonary disease (COPD); anemia; clinical marker

Conflict of interest statement

Conflicts of Interest: CK Rhee reports personal fees from MSD Korea, personal fees from AstraZeneca, personal fees from Novartis, personal fees from Mundipharma, personal fees from Boehringer-Ingelheim, outside the submitted work. YM Oh received payment for lecturing from MSD Korea, AstraZeneca Korea, Boehringer Ingelheim Korea, Novartis, DongWha, Takeda, and GSK Korea. SD Lee received support from Takeda Pharmaceuticals International GmbH for travel to an investigator meeting. He received payment from Takeda Pharmaceuticals International GmbH for attendance at an advisory board. He also received honoraria from GlaxoSmithKline, AstraZeneca, and Boehringer Ingelheim. The other authors have no conflicts of interest to declare.

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